Kailash, V (2013) A Comparative study on the Efficacy of Transesophageal Echocardiography Guidance Versus Anatomical Landmark Technique in the placement of Central Venous Catheter Tip in Pediatric Patients Undergoing Surgery for Congenital Heart Diseases. Masters thesis, Madras Medical College, Chennai.
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Abstract
SUMMARY: By comparing two dimensional transesophageal echocardiography guided central venous catheter tip placement versus anatomical landmark technique guided placement, the following parameters were analyzed: accuracy of central venous catheter tip placement under two dimensional transesophageal echocardiography guidance, insertion length of the catheter placement by various methods, time taken for central venous catheter placement and correlation of post operative chest x-ray in detecting the position of the catheter tip. Using transesophageal echocardiography we were able to achieve 100% accurate placement in SVC-RA junction. Although the duration to establish a central venous access was increased by 10+2 minutes, all possible complications due to catheter tip injury was avoided. Insertion length of the catheter using TEE guidance was at least 1 cm less compared with anatomical landmark technique and Pere’s formula. In pediatric patients even few centimeters of extra insertion may lead to unnecessary fatal complications. CONCLUSION: In pediatric patients undergoing elective cardiac surgery for congenital heart diseases, Transesophageal Echocardiography guided central venous catheter tip placement was more accurate than landmark technique. In this study Transesophageal Echocardiography guided technique was more efficient than the Pere’s method. Transesophageal Echocardiography should be routinely used during central venous cannulation in pediatric patients to avoid catheter related fatal complications. We should make the best use of the existing reliable technology for ensuring patient safety, hence routine identification of central venous catheter tip with Transesophageal Echocardiography has to be done if facility is available.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Transesophageal Echocardiography Guidance ; Anatomical Landmark Technique ; Central Venous Catheter Tip ; Pediatric Patients Undergoing Surgery ; Congenital Heart Diseases ; Comparative study. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 04 Apr 2018 17:26 |
| Last Modified: | 04 Apr 2018 17:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6839 |
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